Jan 29, 2015
From a Patient in Canada
On January 20, 2015
“Thank you, Doctor,
How are you today? Hope well.
My Mom is very grateful for your kind help, mentions your name frequently and wants to schedule the 3rd Rx-SD visit to your office in 2-3 months.
Please provide us with the special 50% discounted price for the procedure similar to the last time in July and the time convenient for you if possible.
Thank you for your help.
My Mom is currently almost free of pain, walks around the house with a walker. The 2nd Rx-SD procedure on July 9,11, 2014 went really well and with the anesthesia was painless. My Mom trusts you, wants to see you every 8-12 months and to start walking without a walker this summer.”
This was the Holiday greeting last month
“Thank you, Doctor,
We wish you a merry Xmas and all the best in 2015.
Thanks to your kindness and knowledge, we found you when we were in real pain and needed you the most and you saved us. My Mom is very gratefull to You, calls you God and mentions your name daily, she’s feeling better only because of your help. My Mom and I both wishing you good health and all the happiness, many years ahead and a Happy New Year 2015.
Thank you for your help
Kind Regards,”
On Oct 7, 2014, at 8:32 AM
“Thank you, Doctor,
3 months passed after the 2nd SD procedure (9 July).
My Mom feels a better improvement now vs right after the 1st procedure.
We have no words to express how grateful we are.
She still uses a walker but occasionally tries a bit on her own with a cane. The pain is almost gone, just occasionally when its rainy or she stands for too long. She didn’t find a great improvement after the PRP refill (2 May), followed by the 1st SD procedure (4 Dec).
What do you think, Doctor, should she just do the 3rd SD procedure in 6-11 months or is it better to do the PRP refill now prior to this. I was surprised to learn the latest Rx SD 2013-14 data show the result doesn’t depend on age (74), OA severity (3), BMI (35).
With BMI=35 what’s the average total hrs per day should she stand/walk?
Thank you for your help.
Kind Regards, “
On Aug 9, 2014, at 12:16 PM
“Thank you, Doctor,
The 2nd SD procedure on 9 July went well and with the knees anesthesia was very painless. After 1 month my Mom feels good, no pain, just a little bit of pain when its humid and raining, still can’t walk without a walker.
My Mom is really grateful for your help and hopes to start walking one day.
Thank you for your help.
Kind Regards,”
Tags: arthritis, Benefits and Risk, Bone Marrow Concentrate, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
Jan 22, 2015
With all of our attention directed to arthritis, patients need to be reminded of the continued successes we are experiencing when using Bone Marrow Concentrate in fractures that fail to heal. When a fracture fails to heal in the expected average time, that is a Delayed Union. When it looses the ability to heal all together, that’s a Non-Union. The reasons that a fracture might fail to heal are beyond the scope of this Blog but non-union is not a rare complication. Areas of predilection toward difficulty in healing have to do with blood supply. The upper end of the femur (hip), navicular bone at the wrist, upper end of the humerus (shoulder), and clavicle as well as the tibia are areas of predilection. Historically, the only remedy has been a major operative procedure and even at that, there is a high failure rate with multiple complications including infection. It has been said that the only thing worse than an infected non-union is cancer. Let me share with you the story of two recent patients for whom I successfully intervened with Bone Marrow Concentrate when prior attempts at achieving fracture healing, one through surgery had failed.
VDVR is a 46-year-old woman who ten years ago sustained multiple fractures to her spine and lower extremities while serving in Iraq. She had undergone numerous surgical procedures, all successful except the inability to cause healing of fractures to her left calcaneus and talus. She had been left with Oxycontin addiction and crutch dependency. After several further orthopedic consultations she had a choice of amputation or more major surgical repair attempts with only 50% chance of success. Twelve weeks ago, I performed a Bone Marrow Concentrate/ Stem Cell intervention to her left calcaneus and talus. Last week she called and indicated she no longer required narcotics and could walk without crutches. The X-ray I received a day or two after the call was indicative of fracture healing.
JM is a 76-year old man with an established non-union of the left clavicle, of several years duration. He was experiencing arthritic changes in his left shoulder and asked me to try and achieve healing of the clavicle, even after several years while I was injecting Bone Marrow Concentrate into his arthritic left shoulder. About 16 weeks ago, I completed a stem cell intervention to his left shoulder and into the area of non-union of the outer one-third of the left clavicle. When I saw him in follow-up last week, the collarbone was completely healed. He had been afraid to undergo a surgical repair because of the high incidence of infection, failure and neurovascular injury associated with surgery of non-union at the clavicle.
These are but two illustrations of what is happening in the new world of Cellular Orthopedics. The initiative is gaining traction in the orthopedic world as I more and more success stories are realized
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Fracture, Interventional Orthopedics, Non-Union Fracture, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenexx, shoulder, stem cells, treatment
Jan 5, 2015
This time of year always brings with retrospection, reviews and prophecy, no matter what area of interest. As my area of professional concern is arthritis and assisting a patient avoid or at least delay a joint replacement, I thought it would be helpful to look at what Outcomes we recorded in our Data Base. Unlike the majority of Regenerative “experts” marketing themselves on the internet, I don’t cite the results of others or make unsupported claims, I document what I learn from having treated patients with Bone Marrow Aspirate Concentrate over two and a half years. Imagine if you would the complexity of having integrated patient care with clinical research using all the parameters I applied to development of new generations of total hip and total knee prosthetics during my almost 40 year joint replacement career. That’s why there are few if any involved in musculoskeletal care via Regenerative Medicine who are able to provide a patient the comprehensive experience I offer.
As of this morning, we have registered over 525 patients in our comprehensive Data Base with measurement pre and post Bone Marrow Aspirate Concentrate/Stem Cell intervention in 125 hips and almost 400 knees. Of the hips, three have gone on to a joint replacement; of the knees, two have gone on to a total knee replacement to the best of my knowledge. What I have defined from my experience is who will benefit from a BMAC intervention and who should undergo a joint replacement. Note the absence of reference to adipose derived stem cells. The explanation is simple; the FDA views such as a drug and hence does not approve the use of fat in the management of arthritis. I am also beginning to get a better understanding about how long the benefits of the intervention will maintain and how to best manage and extend those benefits. In the joint replacement world, the benchmark parameter is survivorship, how long until the prosthesis fails? In the stem cell world, I am interested in observing and prolonging the pain relief and functional improvement after the Bone Marrow Aspirate Concentrate Stem Cell procedure.
Evidence Based Medicine and Best Practices require maintenance of an outcomes data base; not an injection without ongoing follow-up. As I perused the internet this morning, other than Regenexx, I find a paucity of clinical data and a predominance of unsupported claims. In my lifetime of joint replacement surgery, there were many others performing large numbers of procedures around the country. We would meet periodically and present our own scientific outcomes and the evidence and learn from each other, all leading to the best possible clinical practices of total joint replacements. When it comes to the seductive claims from Stem Cell clinics found all over the Web, my challenge this year: Show Me Your Evidence
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Clinical Studies, FDA, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Mature Athlete, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
Dec 29, 2014
Actually it is closer to stem cell misrepresentations and is being propagated by the uninformed clinician, clever marketing schemes, and out and out charlatans. Last week, the FDA made a very strong statement warning against the use of Adipose Derived Stem Cells in the treatment of arthritis. The Government Health Care oversight process stated that there would be large fines and perhaps imprisonment for those health care providers who do not comply with the law. The regulations clearly state that your stem cells may be used if not manipulated or expanded. In order to liberate stem cells from adipose tissue, the adipose tissue has to be treated with an enzyme collagenase, a clear violation of the law. Yet, there are the web sites too numerous to list marketing adipose derived stem cells for arthritis. I am aware of several clinics that circumvent the law by performing liposuction and injecting the fat into the joint without liberating the stem cells with collagenase. My response, beware and take care.
Then come those providers who use local anesthetics to expand the Bone Marrow Aspirate Concentrate when Regenexx has documented the death of stem cells if mixed with local anesthetics. Don’t stop reading, I have yet another alert. The latest addition to the field of Regenerative Medicine comes from Amniotic Fluid that is marketed as an allograft. The pregnant woman at term donates her amniotic fluid that is then processed and made available for wound healing or as an injectate for the arthritic joint in either a concentrated or powder form. While the early outcomes are promising for pain relief, no one has more than four months of outcomes monitoring for amniotic fluid preparations in arthritis. The processing laboratories claim an abundance of stem cells in the concentrate as well as large quantities of Cytokines and Growth Factors; but this is yet to be corroborated by independent researchers. The good news here is the latter research is taking place and more being planned; there should be preliminary data by mid 2015.
Assume if you will that you have an arthritic joint, and are not yet ready for a joint replacement or the extent of your arthritis still lends itself to non-operative management. How can you be sure that you are protected from the abuses I describe above? Regenexx initiated outcomes surveillance over five years ago and as an orthopedic surgeon, I joined and expanded those data points Regenexx studies two and a half years ago. No other Cellular Orthopedic or Regenerative Medicine initiative has the comprehensive Outcomes Data or basic research to support a clinical intervention recommendation, as do the members of the Regenexx Network. Beware here as well of non Regenexx Network web sites that post Regenexx Outcomes as if the patient is too uninformed to recognize the deception. If you want the truth, make an appointment: 847 390 7666
Tags: Amniotic, arthritis, athletes, Bone Marrow Concentrate, Clinical Studies, Interventional Orthopedics, joint replacement, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Regenerative, Regenexx, stem cells, treatment
Dec 1, 2014
Every month, I receive The American Academy of Orthopedic Surgeons News Magazine; in the Clinical News and Views Section, timely issues are reviewed. The November magazine devoted two pages to Surgical vs. Nonsurgical Treatment for Atraumatic Rotator Cuff Tears. The message is “The jury is still out on best course.” Basically, rotator cuff disease is increasing in an aging and active society but the orthopedic surgeon has a difficult time in clinical decision making. The benefits of conservative and surgical options are still controversial.
Our goal of treatment is to relieve pain, restore and maintain function, and provide lasting, durable relief. First of all, imaging studies continually document a high number of Rotator Cuff Tears in patients over 60; but most patients have no symptoms and thus need no treatment. Although the clinical management of Rotator Cuff Tears is highly successful in the short term, the repair often fails in those over 60.
The American Academy’s Clinical Practice Guidelines on “Optimizing the Management of Rotator Cuff Management” found a lack of definitive evidence. The number one recommendation is “exercise and anti-inflammatory medications may be useful in the management of rotator cuff symptoms in the absence of a full-thickness tear.” Highlighted and emphasized is the fact that surgical repair fails in 35% of cases.
An article that appeared in International Orthopaedics , (SICOT); 2014 reviewed Recent Data Showing the Positive Healing Effects from Augmenting a Rotator Cuff Repair (10 Year Follow up). The study documented that significant improvement in healing outcomes could be achieved by the use of Bone Marrow Aspirate Concentrate containing Mesenchymal Stem Cells. More important, studies by Regenexx demonstrated the healing of both symptomatic Atraumatic and Traumatic Rotator Cuff Tears with Bone Marrow Concentrate derived Stem Cells without surgery if the retraction of the torn tendon were minimal. The take home message, if you have shoulder problems, you need a physical examination, X-ray and MRI. For over half of the patient population with symptomatic rotator cuff tears, a BMAC/Stem Cell intervention may relieve symptoms and result in healing
Tags: athletes, bone marrow, Bone Marrow Concentrate, Interventional Orthopedics, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Regenerative, shoulder, stem cells
